Do not attempt resuscitation orders at the emergency department of a teaching hospital
ABSTRACT Objective: To identify factors associated with not attempting resuscitation. Methods: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05). Results: No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. Conclusion: Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
2017
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oai:scielo:S1679-450820170004004092018-01-18Do not attempt resuscitation orders at the emergency department of a teaching hospitalVancini-Campanharo,Cássia ReginaVancini,Rodrigo LuizMachado Netto,Marcelo CalilLopes,Maria Carolina Barbosa TeixeiraOkuno,Meiry Fernanda PintoBatista,Ruth Ester AssayagGóis,Aécio Flávio Teixeira de Heart arrest Cardiopulmonary resuscitation/ethics Resuscitation orders Decision making/ethics Emergency service hospital ABSTRACT Objective: To identify factors associated with not attempting resuscitation. Methods: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05). Results: No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. Conclusion: Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.info:eu-repo/semantics/openAccessInstituto Israelita de Ensino e Pesquisa Albert Einsteineinstein (São Paulo) v.15 n.4 20172017-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082017000400409en10.1590/s1679-45082017ao3999 |
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Vancini-Campanharo,Cássia Regina Vancini,Rodrigo Luiz Machado Netto,Marcelo Calil Lopes,Maria Carolina Barbosa Teixeira Okuno,Meiry Fernanda Pinto Batista,Ruth Ester Assayag Góis,Aécio Flávio Teixeira de |
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Vancini-Campanharo,Cássia Regina Vancini,Rodrigo Luiz Machado Netto,Marcelo Calil Lopes,Maria Carolina Barbosa Teixeira Okuno,Meiry Fernanda Pinto Batista,Ruth Ester Assayag Góis,Aécio Flávio Teixeira de Do not attempt resuscitation orders at the emergency department of a teaching hospital |
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Vancini-Campanharo,Cássia Regina Vancini,Rodrigo Luiz Machado Netto,Marcelo Calil Lopes,Maria Carolina Barbosa Teixeira Okuno,Meiry Fernanda Pinto Batista,Ruth Ester Assayag Góis,Aécio Flávio Teixeira de |
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Vancini-Campanharo,Cássia Regina |
title |
Do not attempt resuscitation orders at the emergency department of a teaching hospital |
title_short |
Do not attempt resuscitation orders at the emergency department of a teaching hospital |
title_full |
Do not attempt resuscitation orders at the emergency department of a teaching hospital |
title_fullStr |
Do not attempt resuscitation orders at the emergency department of a teaching hospital |
title_full_unstemmed |
Do not attempt resuscitation orders at the emergency department of a teaching hospital |
title_sort |
do not attempt resuscitation orders at the emergency department of a teaching hospital |
description |
ABSTRACT Objective: To identify factors associated with not attempting resuscitation. Methods: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05). Results: No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. Conclusion: Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors. |
publisher |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
publishDate |
2017 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082017000400409 |
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